'We're all Florence Nightingales': Managers and nurses colluding in decoupling through contingent roles

Abstract

The present study develops our understanding of the micro-level dynamics of decoupling by addressing how and why various occupational groups, that is, managers and professionals, are involved in decoupling in response to institutional complexity. Our conceptualization of occupational groups' involvement in decoupling emerges from an in-depth qualitative study of 21 managers and 21 nurses in the Dutch home-care sector, where an increasing business logic alongside a professional care logic necessitates a redefinition of occupational jurisdictions and a repositioning of professionals and managers in relation to non-professional caregivers. We contribute by delineating how different occupational groups collude in decoupling in an institutionally complex environment through contingent roles. We show that managers facilitate decoupling through ambiguity regarding multiple institutional logics, and by purposefully abstaining from enacting the business logic in work processes. Nurses in turn deflect institutional pressures by engaging in a classic form of decoupling, that is, complying symbolically with the business logic. We conceptualize how managers' and nurses' occupational commitments and jurisdictions, their relative social positions and other situational conditions are integral to how and why they collude in decoupling through contingent roles. As such, we add to the understanding of micro-level mechanisms and conditions of decoupling.